Africa: Every Two Minutes a Woman Dies in Pregnancy and Childbirth

United Nations, New York — An average of 712 women die every day during pregnancy or childbirth – one woman every two minutes – according to a new United Nations report. Released today, this report finds that a staggering 260,000 women died in 2023, the most recent year for which we have estimates.

Nearly all of these deaths were preventable. Medical advances in delivering respectful, skilled maternity care, coupled with women increasingly claiming their sexual and reproductive rights, has rendered pregnancy and childbirth safer now than at any other time in history. So why are so many women and girls still dying while giving life?

“Maternal deaths are not a medical mystery — they are a global injustice,” said Dr. Natalia Kanem, Executive Director of UNFPA.

Progress, but not for all

Notably, the latest estimates represent a significant – 40 per cent – drop from the 443,000 maternal deaths that took place in 2000. Maternal deaths spiked during the height of the COVID-19 pandemic, and these death rates have, thankfully, receded. But the world remains far from the UN Sustainable Development Goal of reducing maternal mortality to 70 deaths per 100,000 live births by 2030. In fact, the current rate of reduction is roughly 2 per cent annually; to meet the globally agreed goal, maternal deaths must fall by closer to 15 per cent every year.

One core issue is that progress has been highly unequal, and in some countries it has even reversed.

In 2023, the poorest countries accounted for over 43 per cent of all maternal deaths, in part because of a lack of qualified care. Additionally, the most vulnerable pregnant women and girls live in fragile and conflict-affected settings; 37 countries beset by violence and fragility accounted for 61 per cent of all maternal deaths in 2023.

Frontline health workers have long raised alarms about the perils of giving birth in these kinds of settings. In Al Jazirah State, Sudan, a midwife named Awatef told UNFPA that she helped four women deliver babies while fleeing violence: “I delivered them in the bush, with only very basic sterilization – I had nothing but water and soap.”

One woman, Amina, had to give birth by Caesarean section – on the floor of a stranger’s home where a local doctor was assisting deliveries – while listening to the drum of gunfire just outside. “I had to start walking again just six hours later, carrying my baby while my wounds were still fresh and painful,” she said.

Discrimination and unequal access because of location, income, race or ethnicity also deprive women of both sexual and reproductive choices and adequate maternal care. This is true even in the wealthiest countries with mostly high healthcare standards; there, maternal death rates are concentrated among the most marginalized.

A right to skilled healthcare

Yet there are affordable and effective solutions. An initiative launching today highlights that more than two thirds of all maternal and newborn deaths and stillbirths could be averted by quality midwifery care. Still, there remains a chronic global shortage of 900,000 midwives.

Closing this gap would not only be life-saving – it would be cost-effective. Every dollar invested in midwives yields up to a 16-fold return in economic and social benefits, experts have long noted.

UNFPA has seen the transformative power of midwives, who have played a key role in reducing maternal death in the United Republic of Tanzania, where it has fallen by more than 50 per cent, and Sierra Leone, where it has fallen by almost 80 per cent. But with massive global funding cuts threatening essential services, such gains are fragile and hard-won progress risks being derailed.

Today’s initiative – developed jointly by UNFPA, the International Confederation of Midwives (ICM), Jhpiego, UNICEF and WHO – is the ‘Midwifery Accelerator’, a roadmap for training more midwives, deploying them where they’re needed most, and ensuring they are well-equipped, supported and integrated into national health systems.

“Let us prioritize investments so that we reach zero preventable maternal deaths,” Dr. Kanem said in a statement. “Let us commit to building healthier, more just societies and to ensuring that all women bringing life into this world can survive childbirth and thrive afterwards.”